2 Critical Thinking and Evidence-Based Practice 25
Practice Question Components Critical Thinking Standards and Questions
What are the PICO components?
(patient/population/problem,
intervention, comparison with other
treatments if applicable, outcome)
Precision: Can we provide more detail on the
issue? What is the issue? What interventions are
we questioning? Do we want to compare this
with another intervention?
Logic: What is the desired outcome? Does it
really make sense?
State the search question in narrow,
manageable terms.
Precision: Can we be more specific?
What evidence must be gathered? Relevance: How is this evidence connected
to the question? Are we addressing the most
significant factors related to the question?
State the search strategy, database, and
keywords.
Breadth: Do we need to consider other points
of view? Are there other ways to look at the
question?
Critical Thinking and Appraising Evidence
The evidence phase of the PET process requires proficiency in the following
critical thinking skills: seeking information, analyzing, interpreting, and draw-
ing conclusions from available information. The critical analysis, synthesis, and
interpretation of evidence are made explicit by the use of rating scales. These
standardized levels of evidence facilitate differentiating among varying levels and
quality of evidence. The underlying assumption is that recommendations from
high levels of evidence and quality would be more likely to represent best prac-
tices than evidence of lower strength and lesser quality. The rating scale used in
the JHNEBP model to determine level and quality of evidence is in Appendix D.
